Florida Senate - 2016              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. SB 234
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to dental care; creating s. 381.4019,
    3         F.S.; establishing a joint local and state dental care
    4         access account initiative, subject to the availability
    5         of funding; authorizing the creation of dental care
    6         access accounts; specifying the purpose of the
    7         initiative; defining terms; providing criteria for the
    8         selection of dentists for participation in the
    9         initiative; providing for the establishment of
   10         accounts; limiting the number of new accounts that may
   11         be established per fiscal year; requiring the
   12         Department of Health to implement an electronic
   13         benefit transfer system; providing for the use of
   14         funds deposited in the accounts; requiring the
   15         department to distribute state funds to accounts,
   16         subject to legislative appropriations; authorizing the
   17         department to accept contributions from a local source
   18         for deposit in a designated account; limiting the
   19         number of years that an account may remain open;
   20         providing for the immediate closing of accounts under
   21         certain circumstances; authorizing the department to
   22         transfer state funds remaining in a closed account at
   23         a specified time and to return unspent funds from
   24         local sources; requiring a dentist to repay funds in
   25         certain circumstances; authorizing the department to
   26         pursue disciplinary enforcement actions and to use
   27         other legal means to recover funds; requiring the
   28         department to establish by rule application procedures
   29         and a process to verify the use of funds withdrawn
   30         from a dental care access account; requiring the
   31         department to give priority to applications from
   32         dentists practicing in certain areas; requiring the
   33         Department of Economic Opportunity to rank dental
   34         health professional shortage areas and medically
   35         underserved areas; requiring the Department of Health
   36         to develop a marketing plan in cooperation with
   37         certain dental colleges and the Florida Dental
   38         Association; requiring the Department of Health to
   39         annually submit a report with certain information to
   40         the Governor and the Legislature; providing rulemaking
   41         authority to require the submission of information for
   42         such reporting; providing an effective date.
   44  Be It Enacted by the Legislature of the State of Florida:
   46         Section 1. Section 381.4019, Florida Statutes, is created
   47  to read:
   48         381.4019 Dental care access accounts.—Subject to the
   49  availability of funds, the Legislature establishes a joint local
   50  and state dental care access account initiative and authorizes
   51  the creation of dental care access accounts to promote economic
   52  development by supporting qualified dentists who practice in
   53  dental health professional shortage areas or medically
   54  underserved areas or who treat a medically underserved
   55  population. The Legislature recognizes that maintaining good
   56  oral health is integral to overall health status and that the
   57  good health of residents of this state is an important
   58  contributing factor in economic development. Better health,
   59  including better oral health, enables workers to be more
   60  productive, reduces the burden of health care costs, and enables
   61  children to improve in cognitive development.
   62         (1) As used in this section, the term:
   63         (a) “Dental health professional shortage area” means a
   64  geographic area so designated by the Health Resources and
   65  Services Administration of the United States Department of
   66  Health and Human Services.
   67         (b) “Department” means the Department of Health.
   68         (c) “Medically underserved area” means a geographic area so
   69  designated by the Health Resources and Services Administration
   70  of the United States Department of Health and Human Services.
   71         (d) “Public health program” means a county health
   72  department, the Children’s Medical Services Network, a federally
   73  qualified community health center, a federally funded migrant
   74  health center, or other publicly funded or nonprofit health care
   75  program as designated by the department.
   76         (2The department shall develop and implement a dental
   77  care access account initiative to benefit dentists licensed to
   78  practice in this state who demonstrate, as required by the
   79  department by rule:
   80         (a)Active employment by a public health program located in
   81  a dental health professional shortage area or a medically
   82  underserved area; or
   83         (b)A commitment to opening a private practice in a dental
   84  health professional shortage area or a medically underserved
   85  area, as demonstrated by the dentist residing in the designated
   86  area, maintaining an active Medicaid provider agreement,
   87  enrolling in one or more Medicaid managed care plans, expending
   88  sufficient capital to make substantial progress in opening a
   89  dental practice that is capable of serving at least 1,200
   90  patients, and obtaining financial support from the local
   91  community in which the dentist is practicing or intending to
   92  open a practice.
   93         (3) The department shall establish dental care access
   94  accounts as individual benefit accounts for each dentist who
   95  satisfies the requirements of subsection (2) and is selected by
   96  the department for participation. The department may not
   97  establish more than 10 new dental care access accounts per
   98  fiscal year. The department shall implement an electronic
   99  benefit transfer system that enables each dentist to spend funds
  100  from his or her account for the purposes described in subsection
  101  (4).
  102         (4Funds contributed from state and local sources to a
  103  dental care access account may be used for one or more of the
  104  following purposes:
  105         (a) Repayment of dental school student loans.
  106         (b) Investment in property, facilities, or equipment
  107  necessary to establish and operate a dental office consisting of
  108  no fewer than two operatories.
  109         (c) Payment of transitional expenses related to the
  110  relocation or opening of a dental practice which are
  111  specifically approved by the department.
  112         (5Subject to legislative appropriation, the department
  113  shall distribute state funds as an award to each dental care
  114  access account. An individual award must be in an amount not
  115  more than $100,000 and not less than $10,000, except that a
  116  state award may not exceed 3 times the amount contributed to an
  117  account in the same year from local sources. If a dentist
  118  qualifies for a dental care access account under paragraph
  119  (2)(a), the dentist’s salary and associated employer
  120  expenditures constitute a local match and qualify the account
  121  for a state award if the salary and associated expenditures do
  122  not come from state funds. State funds may not be included in a
  123  determination of the amount contributed to an account from local
  124  sources.
  125         (6) The department may accept contributions of funds from a
  126  local source for deposit in the account of a dentist designated
  127  by the donor.
  128         (7) The department shall close an account no later than 5
  129  years after the first deposit of state or local funds into that
  130  account or immediately upon the occurrence of any of the
  131  following:
  132         (a) Termination of the dentist’s employment with a public
  133  health program, unless, within 30 days of such termination, the
  134  dentist opens a private practice in a dental health professional
  135  shortage area or medically underserved area.
  136         (b) Termination of the dentist’s practice in a designated
  137  dental health professional shortage area or medically
  138  underserved area.
  139         (c) Termination of the dentist’s participation in the
  140  Florida Medicaid program.
  141         (d) Participation by the dentist in any fraudulent
  142  activity.
  143         (8) Any state funds remaining in a closed account may be
  144  awarded and transferred to another account concurrent with the
  145  distribution of funds under the next legislative appropriation
  146  for the initiative. The department shall return to the donor on
  147  a pro rata basis unspent funds from local sources which remain
  148  in a closed account.
  149         (9) If the department determines that a dentist has
  150  withdrawn account funds after the occurrence of an event
  151  specified in subsection (7), has used funds for purposes not
  152  authorized in subsection (4), or has not remained eligible for a
  153  dental care access account for a minimum of 2 years, the dentist
  154  shall repay the funds to his or her account. The department may
  155  recover the withdrawn funds through disciplinary enforcement
  156  actions and other methods authorized by law.
  157         (10) The department shall establish by rule:
  158         (a) Application procedures for dentists who wish to apply
  159  for a dental care access account. An applicant may demonstrate
  160  that he or she has expended sufficient capital to make
  161  substantial progress in opening a dental practice that is
  162  capable of serving at least 1,200 patients by documenting
  163  contracts for the purchase or lease of a practice location and
  164  providing executed obligations for the purchase or other
  165  acquisition of at least 30 percent of the value of equipment or
  166  supplies necessary to operate a dental practice. The department
  167  may limit the number of applicants selected and shall give
  168  priority to those applicants practicing in the areas receiving
  169  higher rankings pursuant to subsection (11). The department may
  170  establish additional criteria for selection which recognize an
  171  applicant’s active engagement with and commitment to the
  172  community providing a local match.
  173         (b)A process to verify that funds withdrawn from a dental
  174  care access account have been used solely for the purposes
  175  described in subsection (4).
  176         (11) The Department of Economic Opportunity shall rank the
  177  dental health professional shortage areas and medically
  178  underserved areas of the state based on the extent to which
  179  limited access to dental care is impeding the areas’ economic
  180  development, with a higher ranking indicating a greater
  181  impediment to development.
  182         (12) The department shall develop a marketing plan for the
  183  dental care access account initiative in cooperation with the
  184  University of Florida College of Dentistry, the Nova
  185  Southeastern University College of Dental Medicine, the Lake
  186  Erie College of Osteopathic Medicine School of Dental Medicine,
  187  and the Florida Dental Association.
  188         (13)(a) By January 1 of each year, beginning in 2018, the
  189  department shall issue a report to the Governor, the President
  190  of the Senate, and the Speaker of the House of Representatives
  191  which must include:
  192         1. The number of patients served by dentists receiving
  193  funding under this section.
  194         2. The number of Medicaid recipients served by dentists
  195  receiving funding under this section.
  196         3. The average number of hours worked and patients served
  197  in a week by dentists receiving funding under this section.
  198         4. The number of dentists in each dental health
  199  professional shortage area or medically underserved area
  200  receiving funding under this section.
  201         5. The amount and source of local matching funds received
  202  by the department.
  203         6. The amount of state funds awarded to dentists under this
  204  section.
  205         7. A complete accounting of the use of funds by categories
  206  identified by the department, including, but not limited to,
  207  loans, supplies, equipment, rental property payments, real
  208  property purchases, and salary and wages.
  209         (b) The department shall adopt rules to require dentists to
  210  report information to the department which is necessary for the
  211  department to fulfill its reporting requirement under this
  212  subsection.
  213         Section 2. This act shall take effect July 1, 2016.